RT Journal Article
SR Electronic
T1 Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 632
OP 639
DO 10.1136/thoraxjnl-2019-214177
VO 75
IS 8
A1 Anitha Vijayasingam
A1 Emily Frost
A1 Julie Wilkins
A1 Lise Gillen
A1 Presanna Premachandra
A1 Kate Mclaren
A1 Desmond Gilmartin
A1 Lorenzo Picinali
A1 Alberto Vidal-Diez
A1 Simone Borsci
A1 Melody Zhifang Ni
A1 Wai Y Tang
A1 Deborah Morris-Rosendahl
A1 Jonny Harcourt
A1 Caroline Elston
A1 N J Simmonds
A1 Anand Shah
YR 2020
UL http://thorax.bmj.com/content/75/8/632.abstract
AB Introduction Individuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.Methods Hearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.Results Prevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.Conclusions Adults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.